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Necrotizing soft tissue infection

Necrotizing soft tissue infection


Definition:

Necrotizing soft tissue infection is a rare but very severe type of bacterial infection that can destoy the muscles, skin, and underlying tissue. Necrotizing refers to something that causes tissue death.

Alternative Names:
Necrotizing fasciitis; Fasciitis - necrotizing; Flesh-eating bacteria; Soft tissue gangrene; Gangrene - soft tissue
Causes, incidence, and risk factors:

Many different types of bacteria can cause this type of infection. A very severe and usually deadly form of necrotizing soft tissue infection is due to Streptococcus pyogenes, which is sometimes called "flesh-eating bacteria."

Necrotizing soft tissue infection develops when the bacteria enters the body, usually through a minor cut or scrape. The bacteria begins to grow and release harmful substances (toxins) that:

  • Directly kill tissue
  • Interfere with the blood flow to the tissue
  • Break down materials in the tissue, which rapidly spreads the bacteria, leading to widespread effects such as shock
Symptoms:

The first sign of infection may be a small, reddish painful spot or bump on the skin. This quickly changes to a very painful bronze- or purple-colored patch that grows rapidly. The center may become black and die off. The skin may break open and ooze fluid. The wound may quickly grow in less than an hour.

Symptoms may include general ill feeling, fever, sweating, chills, nausea, dizziness, profound weakness, and finally shock. Without treatment death can occur rapidly.

Signs and tests:

How the skin and tissue look can help the doctor diagnose a necrotizing soft tissue infection. Often a patient will be diagnosed in the operating room by a surgeon. Imaging tests, such as CT scans, are sometimes helpful.

Tests performed on blood, fluids, or tissue from the area may determine the bacteria that is causing the infection.


Review Date: 12/3/2007
Reviewed By: D. Scott Smith, M.D., MSc, DTM&H, Chief of Infectious Disease & Geographic Medicine, Kaiser Redwood City, CA & Adjunct Assistant Professor, Stanford University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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